title: High blood pressure accelerates gait slowing in well-functioning older adults over 18-years of follow-up.
abstract: OBJECTIVE
  To examine whether the association between hypertension and decline in gait speed is significant in well-functioning older adults and whether other health-related factors, such as brain, kidney, and heart function, can explain it.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Cardiovascular Health Study.
  
  
  METHODS
  Of 2,733 potential participants with a brain magnetic resonance imaging (MRI) scan, measures of mobility and systolic blood pressure (BP), no self-reported disability in 1992 to 1994 (baseline), and with at least 1 follow-up gait speed measurement through 1997 to 1999, 643 (aged 73.6, 57% female, 15% black) who had received a second MRI in 1997 to 1999 and an additional gait speed measure in 2005 to 2006 were included.
  
  
  METHODS
  Mixed models with random slopes and intercepts were adjusted for age, race, and sex. Main explanatory factors included white matter hyperintensity progression, baseline cystatin-C, and left cardiac ventricular mass. Incidence of stroke and dementia, BP trajectories, and intake of antihypertensive medications during follow-up were tested as other potential explanatory factors.
  
  
  RESULTS
  Higher systolic BP was associated with faster rate of gait speed decline in this selected group of 643 participants, and results were similar in the parent cohort (N = 2,733). Participants with high BP (n = 293) had a significantly faster rate of gait speed decline than those with baseline BP less than 140/90 mmHg and no history of hypertension (n = 350). Rates were similar for those with history of hypertension who were uncontrolled (n = 110) or controlled (n = 87) at baseline and for those who were newly diagnosed (n = 96) at baseline. Adjustment for explanatory factors or for other covariates (education, prevalent cardiovascular disease, physical activity, vision, mood, cognition, muscle strength, body mass index, osteoporosis) did not change the results.
  
  
  CONCLUSIONS
  High BP accelerates gait slowing in well-functioning older adults over a long period of time, even for those who control their BP or develop hypertension later in life. Health-related measurements did not explain these associations. Future studies to investigate the mechanisms linking hypertension to slowing gait in older adults are warranted.
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. rosanoc@edc.pitt.edu
authors.forename: Caterina
authors.initials: C
authors.lastname: Rosano
authors.forename: William T
authors.initials: WT
authors.lastname: Longstreth
authors.forename: Robert
authors.initials: R
authors.lastname: Boudreau
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Taylor
authors.forename: Yan
authors.initials: Y
authors.lastname: Du
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D000959:Antihypertensive Agents